Societal health status is commonly measured by infant and child health status. Although there is racial/ethnic variation in child health outcomes in the United States, our knowledge of the health or Latino children is very limited. The purpose of this study is to investigate child health outcomes in Latinos, the second largest minority group. In this proposal we will analyze the influence of acculturation and community factors on child health outcomes in Latinos. The specific aims of the project are: (1) To determine the strength of the association between maternal acculturation and child health outcomes, as measured by child health status, growth and development immunization status, and utilization of pediatric care; (2) to measure the relationship between maternal utilization of prenatal care, immunization status, and utilization of pediatric care; and (3) To determine whether the relationship between maternal acculturation and child health outcomes can be explained by community socioeconomic and cultural characteristics. In this study we will prospectively follow a cohort of 350 Latino women and their infants at San Francisco General Hospital over a three year period. We will conduct three study visits in the General Clinical Research Center when the child on one, two, and three years old. The dependent variables are child health status, growth and development, immunization status,, and utilization of pediatric care. The primary independent variables are maternal acculturation and community socioeconomic and cultural characteristics. Using a combination of structured interviews, biological measures and community assessments, we will prospectively obtain information on factors that influence child health outcomes, with an emphasis on the independent influence of acculturation and other sociocultural factors. We hypothesize that increased maternal acculturation has an adverse effect on child health outcomes; that inadequate utilization of prenatal care is associated with non-up to date immunizations and inadequate utilization of pediatric care; and that the relationship between increased maternal acculturation and adverse child health outcomes is partially explained by the socioeconomic and cultural characteristics of the community.